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目的了解金属制造业噪声作业工人上岗前听力损失情况,分析其影响因素。方法采用判断抽样的方法,以1 597名行上岗前职业健康检查的金属制造业拟从事噪声作业的工人为研究对象,收集其上岗前职业健康检查的相关资料,分析其听力损失情况及影响因素。结果 1 597名研究对象中,631人(占39.5%)既往有接触职业性噪声(有噪声接触史组),接触工龄M为0.20(0.10~0.30)年;966人(占60.5%)既往无接触职业性噪声(无噪声接触史组)。听力损失检出率为46.1%(737/1 597);其中,职业禁忌证检出率为13.9%(222/1 597),其他类型听力损失检出率为32.2%(515/1 597)。有噪声接触史组人群职业禁忌证和其他类型听力损失的检出率均高于无噪声接触史组(16.5%vs 12.2%,50.6%vs 43.3%,P<0.05)。对于职业禁忌证和其他类型听力损失,男性人群的发生风险均高于女性[优势比(OR)分别为1.958、2.331,P<0.01],年龄>25岁人群的发生风险均高于年龄≤25岁者(OR分别为2.390、2.245,P<0.01),既往有职业性噪声接触史人群的发生风险均高于无职业性噪声接触史者(OR分别为1.536、1.287,P<0.05)。结论开展噪声作业人员上岗前职业健康检查有利于早期发现职业禁忌证;应重视男性、年龄较大以及既往有职业性噪声接触史人员的上岗前职业健康检查。
Objective To understand the hearing loss of noise workers in metal manufacturing before their posts, and analyze the influencing factors. Methods The method of judgment sampling was used to investigate the occupational health check-ups of 1,559 workers in the metal manufacturing industry engaged in pre-appointment occupational health examinations for noise-induced occupational diseases and to analyze their hearing loss and its influencing factors . Results Among 1 597 study participants, 631 (39.5%) had contact occupational noise (noisy contact history), 0.20 (0.10-0.30) years of contact occupational exposure, and 966 (60.5%) had no previous experience Exposure to occupational noise (no-noise history of exposure group). The detection rate of hearing loss was 46.1% (737/1 597). Among them, the detection rate of occupational contraindications was 13.9% (222/1 597) and that of other types of hearing loss was 32.2% (515/1 597). Occupational contraindications and other types of hearing loss were higher in the noisy exposure history group than in the no noise exposure history group (16.5% vs 12.2%, 50.6% vs 43.3%, P <0.05). For occupational contraindications and other types of hearing loss, the risk for males was higher than that for females (OR = 1.958, 2.331, respectively; P <0.01), and the risk for those> 25 years of age was significantly higher than those for ≤25 (OR = 2.390,2.245, P <0.01). The risk of occupational noise exposure in history was higher than those without occupational noise exposure (OR = 1.536,1.287, P <0.05, respectively). Conclusion To carry out pre-employment occupational health examination for noise operators is beneficial to early detection of occupational contraindications. Pre-employment occupational health examination should be emphasized in male, older and former workers with occupational noise exposure history.